Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.79 / $65.98 / $98.10	Facility		$52.79	$65.98	$98.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $41.35 / $172.97	Professional		$23.32	$41.35	$172.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.58 / $114.37 / $120.97	Facility		$94.58	$114.37	$120.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.72 / $26.83 / $182.01	Professional		$21.72	$26.83	$182.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.34 / $119.45 / $124.16	Facility		$29.34	$119.45	$124.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.75 / $141.11 / $216.46	Facility		$120.75	$141.11	$216.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $118.46 / $134.61	Professional		$50.39	$118.46	$134.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $23.32 / $52.79	Facility		$23.32	$23.32	$52.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $36.07 / $379.10	Facility		$23.32	$36.07	$379.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $43.99 / $121.85	Professional		$26.39	$43.99	$121.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $55.00 / $86.23	Professional		$22.00	$55.00	$86.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.32 / $23.32 / $52.79	Facility		$23.32	$23.32	$52.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $107.71 / $745.62	Professional		$53.77	$107.71	$745.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $379.10	Facility		$87.98	$87.98	$379.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.31 / $34.29 / $54.10	Professional		$23.31	$34.29	$54.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $45.26 / $45.26 / $93.68	Professional		$45.26	$45.26	$93.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $45.26 / $45.26 / $240.19	Professional		$45.26	$45.26	$240.19
United Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $35.19 / $43.99	Facility		$22.00	$35.19	$43.99
United Facility/Professional Professional Modifier Low / Median / High Price $25.51 / $36.29 / $129.07	Professional		$25.51	$36.29	$129.07